富阳市滥用新型毒品羁押人群的相关行为特征分析

目的了解富阳市滥用新型毒品的羁押人群的相关危险行为情况。方法于2012年1月至2013年11月,对富阳市公安机关查获的273名新型毒品滥用者进行问卷调查,并抽血检测梅毒、丙型肝炎病毒(HCV)和艾滋病病毒(HIV)抗体等。结果 273名新型毒品滥用者使用新型毒品以"烫吸"方式为主,存在注射毒品和共用针头现象。39.19%的被调查者承认在使用新型毒品后1小时内发生性行为,5.16%承认有同性性行为,男性发生性行为的比例高于女性,达41.53%。被调查人群性交方式以阴道性交为主,性伴以临时性伴和男/女朋友为主,安全套使用率较低,24.30%的被调查对象近三个月中每次都不使用安全套。273名调查对象的梅毒感染率为9.16%(25/273),HCV感染率为9.89%(27/273),未发现HIV感染者(检验数据来源于中心实验室)。结论吸食新型毒品者的高危性行为比例较高,性别是使用新型毒品后即发生性行为的影响因素,为防控艾滋病等传染病在吸毒人群中的感染和可能的流行,应重点加强男性新型毒品吸食者的健康教育及高危行为干预和提高新型毒品吸食者的安全套使用率。     

青岛市男男性行为者中滥用新型毒品者的艾滋病相关性行为特征

目的了解滥用新型毒品对青岛市男男性行为者(MSM)艾滋病相关高危行为及艾滋病病毒(HIV)感染状况的影响。方法采用滚雪球的方法招募青岛市MSM中的新型毒品滥用者与未滥用者。面对面调查其人口学、性行为等特征。采集静脉血检测HIV和梅毒抗体,采集尿液检测新型毒品滥用情况。采用多因素Logistic回归分析滥用新型毒品与性行为特征间的关系。结果共招募调查对象602人,其中新型毒品滥用者和未滥用者分别为302人(50.2%)和300人(49.8%)。最近半年有商业性伴者占比滥用组(22.2%)高于未滥用组(10.7%)(P0.01)。最近半年同性固定性伴肛交行为安全套坚持使用率滥用组(13.0%)低于未滥用组(33.1%)(P0.01)。滥用组发生群交行为者占比(68.5%)高于未滥用组(23.3%)(P0.01)。调查对象各类性伴性行为安全套坚持使用率滥用组(15.2%)低于未滥用组(27.3%)(P0.01),安全套破损率滥用组(53.6%)高于未滥用组(32.0%)(P0.01)。在校正两组的婚姻状况、户籍、月收入、居住时间和性行为偏好等因素后,滥用毒品者与未滥用者相比,同性商业性伴、群交、安全套破损等行为发生的可能性更高(P0.05);同性固定性伴肛交行为坚持使用安全套,各类性伴性行为中均坚持使用安全套等行为发生的可能性更低(P0.05)。调查对象HIV和梅毒抗体阳性率分别为0.7%(4/602)和4.3%(26/602),新型毒品滥用者HIV和梅毒抗体阳性率分别为0.3%(1/302)和2.6%(8/302)。结论青岛市MSM新型毒品滥用者较未滥用者流动性、性活跃程度高,安全套使用率低,安全套破损率高,HIV感染风险高,应加强对其开展高危行为干预。     

新型毒品吸食者多性伴性行为特征及影响因素分析

目的了解新型毒品吸食者多性伴性行为发生情况并探讨其影响因素。方法抽取成都市强制戒毒所的新型毒品吸食者进行问卷调查,使用SPSS 21.0软件进行统计学分析。结果 220名调查对象中,男性占78.6%(173人),20~29岁占42.9%(94/219)。33.7%(83人)的承认自己有多性伴性行为,74.5%(164人)的表示其有固定性伴,18.2%(40人)的承认其发生过商业性行为,29.1%(64人)的发生过临时性行为。多因素Logistic回归分析显示:性别、吸食年限、吸食频率、每次吸毒平均花费为多性伴的影响因素(P0.05)。结论新型毒品吸食者易发生多性伴行为、无保护性行为,应开展综合干预措施,减少不安全性行为的发生。     

重庆市使用新型毒品的男男性行为者感染HIV的影响因素

目的了解与分析重庆市使用新型毒品的男男性行为者(MSM)亚人群的艾滋病相关行为以及艾滋病感染状况。方法依托男同社区小组,通过固定检测点咨询、朋友介绍、网络招募、同伴推荐等方式,招募使用新型毒品的MSM,进行问卷调查和艾滋病病毒(HIV)检测。结果共调查200名使用新型毒品的MSM。首次使用毒品的平均年龄为(22.5±3.6)岁。冰毒是调查对象首次和最近半年使用的主要毒品,分别占86.0%和91.0%,最近6个月使用过助性剂的占62.0%。使用新型毒品后发生肛交或口交的比例高达99.5%,而最近半年坚持使用安全套的仅占15.0%。使用新型毒品后,与固定性伴发生性行为时,最近一次使用安全套的比例为24.6%%。此外,使用新型毒品后,56.5%的发生了群交性行为,群交过程中能始终使用安全套的比例仅为6.2%。第一次快检HIV抗体阳性率为37.1%(52/140),确认阳性率为14.3%。HIV感染多因素Logistic回归分析发现,首次吸毒年龄越低[比值比(OR)=2.958,95%可信区间(CI):1.185~7.384],使用新型毒品越频繁(OR=3.664,95%CI:1.847~7.269),近半年安全套使用率越低(OR=3.838,95%CI:1.413~10.985),HIV感染的风险更高。结论使用新型毒品的MSM亚人群不安全性行为非常普遍,亟须采取进一步的综合性防治措施。     

男男性行为者对利用手机社交软件推送HIV防控信息的接受意愿调查

目的探讨使用手机社交软件(APP)寻找性伴的男男性行为者(MSM)对利用手机社交软件推送艾滋病病毒(HIV)防控信息的接受意愿及其相关因素。方法采用滚雪球及同伴推动抽样(RDS)方法在沈阳招募MSM研究对象,通过面对面访谈式问卷调查获取研究对象的人口学、行为学信息、手机社交软件使用情况及对HIV防控信息推送的接受意愿,采用多因素Logistic回归分析MSM对利用手机APP推送HIV防控信息接受意愿及影响因素。结果自报曾使用手机APP寻找性伴的MSM占61.5%(464/755),32.5%(151/464)的MSM同时使用2种及以上APP寻找性伴,49.6%(230/464)的MSM至少每天使用一次手机APP。使用手机APP寻找性伴的MSM相对未使用者更年轻、使用过新型毒品的比例更高、同性性行为中做被插入方的比例更高且近3个月有更多的偶然性伴(P均0.05)。使用手机APP的MSM对利用手机APP推送HIV防控信息的接受率为58.0%。多因素Logistic回归分析显示,自报性取向为同性、使用手机APP时间1年、同时使用2种及以上手机APP以及至少每天使用1次手机APP是MSM接受HIV防控信息推送意愿的独立影响因素(P均0.05)。结论沈阳市使用手机APP的MSM高危行为更突出,且使用手机APP累计时间长、频率高、种类多的MSM更愿接受HIV防控信息推送,提示卫生部门应与手机APP软件供应商协作,利用手机APP平台推送针对MSM的HIV防控信息,以控制MSM的HIV疫情增长。     

农村50岁及以上在婚男性性需求及性行为现况调查

目的了解农村地区50岁及以上在婚男性的性需求、以及不同类型的性行为现况,为今后在该人群中促进健康性行为、探索降低HIV/性病感染风险相关措施提供参考。方法 2018年1月和7月,分别在湖南省邵阳县、四川省荥经县开展横断面调查,调查形式为电子问卷。使用SPSS 26.0软件进行整理分析。不同特征人群的性需求,单因素分析使用χ2检验,多因素分析使用二项Logistics回归分析。结果共调查437名50岁及以上在婚男性。279名(63.8%)调查对象自报平时有性需求,不同年龄、文化程度、是否有夫妻分居经历、不同的夫妻关系评分,其性需求比例的差异有统计学意义。330名调查对象(75.5%)过去一年和配偶有性行为。和配偶性行为频率小于4次/月占83.0%(274/330);自报50岁以后发生过商业性行为的有9人(2.1%)、找过情人的有2人(0.5%)。结论农村50岁及以上在婚男性有较高的性需求,需采取综合的健康教育策略,一方面促进与配偶科学的性行为,减少非婚异性性行为发生的可能性;另一方面需提升HIV/性病的正确认知和风险意识,减少感染风险。     

学生中122名男男性行为者HIV/STD高危行为及其感染状况分析

目的了解男男性接触者(MSM)的学生亚群中艾滋病病毒/性传播疾病(HIV/STD)感染高危性行为及其感染状况。方法采用应答者驱动、关键知情人介绍、网上公告等方法在安徽省合肥市招募,共有122名符合条件的MSM完成了面对面问卷调查,其中121人参加了HIV和梅毒检测。调查内容主要包括社会人口学特征、艾滋病知识和感染意识、主要社会活动场所、性伴和性行为特征。结果79.5%的调查对象为大学生及研究生,20.5%为高中生。HIV检测阳性率为1.7%,梅毒现感染率7.4%。82.0%调查对象近6个月有同性肛交性伴,24.6%有2个以上固定性伴,39.3%有偶然性伴;性伴平均年龄大于调查对象的平均年龄(P<0.001)。63.1%的调查对象近6个月内有过无保护同性肛交行为,与固定性伴发生无保护肛交(插入或被插入)均高于同偶然性伴(P<0.05)。大多数MSM艾滋病知识缺乏,他们获得艾滋病知识的主要途径是因特网、报纸、电视等媒体。结论要加强在校学生性病艾滋病健康教育,倡导单一固定性伴关系和安全性行为观念,并推广安全套使用。     

广州市部分在校学生MSM的艾滋病危险行为特征分析

目的了解广州市在校学生男男性行为者(MSM)艾滋病相关危险行为的特征。方法于2014年3-8月,在广州市知名的同志网站招募668名学生MSM,调查其人口学特征、艾滋病相关知识、HIV抗体检测史、毒品及物质滥用史、性病感染史、近3个月性行为特征等。结果 668名学生MSM中,35.0%(234-人)既往性伴主要是社会人员,48.2%(322人)既有社会人员又有学生。最近3个月,68.1%(455人)与男性发生过肛交性行为,其中29.3%(196人)发生过无保护肛交性行为;28.6%(191人)与多个性伴(≥2个)发生过肛交性行为,性伴数最多为18个;7.9%(53人)发生过"群交"性行为;19.8%(132人)使用过Rush、零号胶囊或伟哥等物质。9.1%(61人)自报曾感染过性病。结论广州市学生MSM无保护肛交、多性伴、"群交"等艾滋病相关高危行为普遍存在,物质滥用情况较为严重,性伴网络社会化特征明显,亟须在目标人群中加强艾滋病相关高危行为的警示性教育,以遏制艾滋病疫情的进一步蔓延。     

上海市西部三区MSM人群的HIV相关行为学特征及影响因素

目的了解上海市西部三区男男性行为人群(Men who have sex with men,MSM)艾滋病病毒(Humanimmunodeficiency virus,HIV)感染相关行为学特征,以及发生无保护男男性行为的影响因素。方法通过非政府社会小组和社会信息网络,对上海西部三区MSM人群进行宣传和动员,并按照研究要求进行筛选,使用统一问卷,采用面对面一对一方式调查。结果共调查424名MSM,平均年龄为(26.84±6.69)岁;未婚者占90.1%(382/424);教育程度较高;半数以上受访者月均收入≥3 000元。受访者初次和男性发生性行为的平均年龄为(21.15±4.46)岁;过去半年内受访者的平均性伴数为(2.99±3.77)人。目前有固定男友的受访者占60.6%(257/424),但在半年内和固定男友间在性行为上相互忠贞的只有38.1%(98/257)。调查发现,162名受访者半年内曾有过无保护男男性行为,其中有固定男友的受访者发生无保护男男性行为的比例高于无固定男友者。与和男性发生无保护性行为相关的影响因素为月均收入和半年内男性性伴人数。此外,受访者寻找性伴最常见的方式是通过网络。同时也发现,常在男浴室和公园、公厕寻找性伴的MSM,发生无保护性行为的比例较在其他场所寻找性伴的MSM更高。61.8%(262/424)的受访者认为自己有感染HIV的风险,424名MSM中312人既往曾进行过HIV检测。结论 MSM人群性行为特征方面存在多种与HIV感染相关的高危因素,浴室和公园、公厕应作为MSM人群HIV干预的重点场所;以月均收入较低、性伴数量较多的MSM,发生无保护性行为的概率较高。应加强对此类人群的HIV相关健康干预。     

山东省新型毒品滥用人群吸毒相关行为的定性研究

目的了解山东省新型毒品滥用者吸毒相关的行为特征,为艾滋病干预工作提供参考。方法在监管场所和社区招募28名新型毒品滥用者,对每名吸毒者单独进行深入访谈,每人次访谈约2小时,了解吸毒者的吸毒行为和性行为等情况。结果28名新型毒品滥用者中,目前滥用的新型毒品主要是冰毒,滥用方式为烫吸,吸毒者中存在混吸现象,平均每周吸食一次冰毒,宾馆是主要的滥用场所,同伴提供是获取毒品的主要来源。新型毒品有增强性功能的作用,64．3％有多个性伴,多数已婚的吸毒者有婚外性行为,发生性行为时很少使用安全套。结论新型毒品滥用人群中高危性行为普遍,多数未接受过艾滋病预防服务,有必要加强艾滋病健康教育等干预措施。     

Sexual transmissibility of HIV among opiate users with concurrent sexual partnerships: an egocentric network study in Yunnan, China

Aims To investigate the patterns of concurrent sexual partnerships among young opiate users and sexual transmissibility of human immunodeficiency virus (HIV) in concurrent sexual partnerships in drug‐use and sexual networks. Design Cross‐sectional design. Participants A total of 426 young opiate users in Yunnan, China. Setting Young opiate users recruited from their network ties. Measurement Respondent‐driven sampling (RDS) was used to recruit participants. Multiple logistic regressions were performed to analyze the relationships of concurrent sexual partnerships with egocentric social network components, risky sexual behavior for HIV and drug‐use practices. Findings The RDS‐adjusted prevalence of concurrent sexual partners was 42.9% among opiate users. Opiate users with concurrent sexual partnerships were more likely to engage in risky HIV‐related sexual behavior, compared to those without. Specifically, they were more likely to report having had four or more sexual partners (26.3% versus 2.0%), having had a spouse or boy/girlfriends who also had concurrent sexual partnerships (28.1% versus 8.2%), having exchanged drug for sex (12.4% versus 3.8%), having had sexual partners who were non‐injection drug users (22.6% versus 10.1%), having had sexual partners who were injection drug users (25.3% versus 13.5%) and having used club drugs (26.3% versus 13.5%). There were no significant differences in consistent condom use between opiate users with sexual concurrency and those without. The same proportion (25.8%) of opiate users in the two groups reported having consistently used condoms when having sex with regular partners, and 46.3% of opiate users with sexual concurrency and 36.4% of those without such concurrency consistently used condoms with non‐regular partners. Conclusion The expansion of the human immunodeficiency virus epidemic from high‐risk populations to the general population in China may be driven by concurrent sexual partnerships. Behavioral interventions targeting safer sex should be integrated into harm reduction programmes.     

Sexual Risk Behaviors among Club Drug Users in Shanghai, China: Prevalence and Correlates

We surveyed 276 club drug users in Shanghai, China. Overall, 43.8 % reported ≥2 sex partners in the past 30 days, and 48.9 % reported having sex with non-regular partners, 67.4 % of whom had unprotected sex. Having ≥2 recent sex partners was associated with being 35 years or older, male, living with friends or others, introduced to club drug use by non-regular sex partners, using methamphetamine recently, self-identified as gay/lesbian or bisexual, had sexual debut before 20 years old, and recently had sex under the influence of drugs. Having unprotected sex with non-regular partners in the past 30 days was associated with lower education levels, having sex to obtain drugs, and lower levels of HIV/AIDS knowledge. Club drug users should be targeted for intervention programs. Future research needs to identify other protective and risk factors for sexual risk behaviors and design interventions to reduce club drug use and associated sexual risk behaviors.     

北京地区部分新型毒品滥用者HIV／STIs感染现状调查

目的了解北京地区新型毒品滥用者艾滋病病毒（HIV）、梅毒、单纯疱疹病毒Ⅱ型（HSV-2）、丙型肝炎病毒（HCV）和乙型肝炎病毒（HBV）的感染情况。方法采用横断面设计的方法,于2009年10-12月,在北京市某强制戒毒所对其收治的主要吸食冰毒等新型毒品者进行问卷调查,采集血液标本,检测HIV、梅毒、HSV-2、HCV和HBV表面抗原（HBsAg）。结果 151名新型毒品滥用者中,分别有39.1%、10.5%的人多药使用和混合用药,无人注射新型毒品;承认新型毒品使用后发生性行为的人占55.6%;在过去1年中,性伴数在180人不等;仅27.4%的人每次性行为时都使用安全套;HIV、梅毒、HSV-2、HCV和HBV的感染率分别是0.7%、13.9%、60.3%、19.2%和11.5%。结论新型毒品滥用者仍是以非注射吸食为主,在毒品作用下易发生无保护性行为,是艾滋病性传播感染（STIs）的潜在高危人群。     

The relationship between social network characteristics and exchanging sex for drugs or money among drug users in Baltimore, MD, USA

The current study examined social network and drug use factors associated with buying and selling sex among a sample of opiate and cocaine users in Baltimore, Maryland. A sample of 702 drug users who were sexually active were administered a social network and risk behaviour inventory. Compared to 25% of men, only 1.7% of women reported a history of giving money or drugs to get sex during the past 90 days. Conversely, more women (21.2%) than men (4.7%) sold sex for money or drugs. Those who sold sex were more likely to be low frequency crack smokers, were more likely to drink alcohol at least once a day, had a higher average number of crack-only smokers in their network, and had a smaller number of kin in their network. Men who exchanged money or drugs for sex tended to be low frequency crack smokers and reported having more crack-only smokers and injectors and fewer kin in their networks. The results suggest that network composition may be a risk factor for exchanging sex, particularly with respect to crack users, while kin may be a protective factor. These associations may be either a cause or consequence of exchanging sex.     

Impact of HAART-related side effects on unsafe sexual behaviours in HIV-infected injecting drug users: 7-year follow up

OBJECTIVE: To investigate the impact of non-lipodystrophy HAART-related side effects on unprotected sexual behaviours among HIV-infected drug users. DESIGNAND PARTICIPANTS: HAART-treated patients who reported having occasional partners during the follow-up period after HAART initiation were selected among patients of the MANIF 2000 cohort of HIV-infected drug users. METHODS: Visits where patients reported unsafe sexual behaviours with occasional partners were compared to visits where they reported safe sexual behaviours using a logistic model based on Generalized Estimating Equations. RESULTS: One-hundred and ninety-two HAART-treated patients reported occasional sexual partners at least once during follow-up, accounting for a total of 464 visits. Among these 192 patients, 134 (70%) declared at least once unsafe sexual behaviours with occasional partners. During follow-up, three or more HAART-related side effects were reported in 273 of the 464 visits. When comparing visits where patients reported unsafe sexual behaviours with occasional partners (n = 249) with those where they reported safe sexual behaviours (n = 215), experiencing three or more HAART-related side effects was significantly associated with unsafe sex after adjustment for cofactors such as injecting drug status, reporting more than two sexual partners and having sex more than once a week. CONCLUSIONS: Perceived side effects play a role in determining unsafe sexual behaviours. HIV prevention interventions must consider the negative impact of HAART-related side effects on sexual risk-taking behaviours. Drug maintenance programs contribute to sexual risk reduction among drug injecting patients.     

The Influence of Gender on Factors Associated with HIV Transmission Risk Among Young Russian Injection Drug Users

HIV infection rates are dramatically increasing in the Russian Federation. Epidemiological studies indicate that the greatest rise of HIV incidence has been among injection drug users (IDU). Young adults (N = 188) who reported injecting drug use completed surveys and interviews that assessed injection drug use behavior, sexual behavior, and HIV‐related knowledge. The average age of participants was 21.3 years. Multiple linear regression analysis found male gender and younger age at sexual debut was positively and significantly associated with having multiple sexual partners. Gender moderated the effects of sexual debut and number of times injected drugs were used in the past month. Males who initiate sex at a younger age were more likely to report multiple sex partners and females who reported higher frequency of drug use were more likely to report multiple sex partners. Gender is an important factor, as well as moderator of risk behavior among Russian injection drug users. Delaying sexual debut, particularly for males, may be an effective strategy to reduce subsequent risk behavior. Prevention efforts among IDUs need to address sexual risk behavior in conjunction with injection risk behavior.     

The influence of gender on factors associated with HIV transmission risk among young Russian injection drug users

HIV infection rates are dramatically increasing in the Russian Federation. Epidemiological studies indicate that the greatest rise of HIV incidence has been among injection drug users (IDU). Young adults (N = 188) who reported injecting drug use completed surveys and interviews that assessed injection drug use behavior, sexual behavior, and HIV-related knowledge. The average age of participants was 21.3 years. Multiple linear regression analysis found male gender and younger age at sexual debut was positively and significantly associated with having multiple sexual partners. Gender moderated the effects of sexual debut and number of times injected drugs were used in the past month. Males who initiate sex at a younger age were more likely to report multiple sex partners and females who reported higher frequency of drug use were more likely to report multiple sex partners. Gender is an important factor, as well as moderator of risk behavior among Russian injection drug users. Delaying sexual debut, particularly for males, may be an effective strategy to reduce subsequent risk behavior. Prevention efforts among IDUs need to address sexual risk behavior in conjunction with injection risk behavior.     

A contextual profile of club drug use among adults in Chicago

Aims To better understand the prevalence, correlates, risk factors and context of club drug use among US adults in the City of Chicago. Design An Audio Computer‐Assisted Self Interview was administered to a household probability sample of adults, aged 18–40 years, from June 2001 to January 2002. Setting Subjects were drawn from randomly selected households using a multi‐stage area probability design. Participants The data represent 627 randomly selected adult participants. Measurement Weighted prevalence estimates with design‐effect adjusted confidence intervals of life‐time, past 12 month and past 30 day use of any club drug and of specific club drugs; prevalence of rave attendance, other drug use, motivation for use among club drug users; χ² tests of significance, logistic regression and adjusted odds ratios. Findings Overall club drug prevalence rates were nearly twice those obtained for MDMA alone. Club drug users were more likely to use multiple illicit substances and to report having been in treatment for substance use. A majority of life‐time club drug users never attended a rave although rave attendees were more likely to report frequent use of MDMA. Use was associated with gender, race and sexual orientation. Conclusions Prevention research should be informed by further population‐based research on club drug use. Research should not focus exclusively on rave attendees, as they are only a subset of club drug users. Research is needed on neurological and behavioral sequelae across different types of club drugs, gender differences in the impact of sexual orientation on club drug risk and on the effects of personality characteristics such as sensation seeking on club drug use behavior.